The sensory role of the sole of the foot: Review and update on clinical perspectives

The feet constitute an important sensory structure in the mechanisms of postural control. As a direct and often only interface between the body and the ground, the feet allow us to sense and interact with our environment. Sensory information provided by muscle and cutaneous afferents in the foot contribute to our ability to stand upright, and postural sway is necessary to detect both position and motion of the body in space. A decline in foot sole skin sensitivity occurs naturally with aging and as a result of neurological disorders, including different peripheral neuropathies, the commonest etiologies of which are diabetes mellitus or effects of chemotherapy. This decline in sensitivity is frequently associated with poorer postural control and increased risk of falls in these populations. The purpose of this comprehensive review is to summarize the evidence that supports a functional role of foot sole sensory tactile and muscular feedback in standing balance, and the postural consequences when this feedback is impaired with aging or disease. This brings new clinical perspectives on the development of intervention strategies to improve the quality of foot sole cutaneous feedback. It also seems to be a promising approach in the management of patients with balance disorders, with specific chronic pain syndromes, with neurologic diseases or those at risk of falling.